Seemingly healthy 71-year-old men with minor elevations of cardiac troponin I and at risk of premature death in CVD have elevated levels of NT-proBNP: report from the ULSAM study.

摘要

BACKGROUND: Hypersensitive cardiac troponin I (cTnI) assays detect even minor elevations of cTnI. Previous findings identifying a group of seemingly healthy elderly men with very minor elevations of cTnI have shown that these men were at risk of premature cardiovascular death. OBJECTIVES: To study the association between cTnI concentrations and cardiovascular risk factors and subclinical cardiac and renal target organ damage in a community-based sample of elderly men. METHODS: Biomarkers reflecting glucose and lipid metabolism, renal function, cardiac function and inflammation were measured in the ULSAM study (n = 1205, mean age 71 years). The participants were placed in three subgroups based on the cTnI concentrations: a low group with cTnI <0.02 microg/L, an intermediate group with cTnI between 0.02 and 0.039 microg/L and a high group with cTnI >0.039 microg/L. RESULTS: In the entire cohort of 71-year-old men, most markers of glucose and lipid metabolism, renal function, inflammation and NT-proBNP were significantly related to the concentrations of cTnI, and most obviously in the high-cTnI group. In subjects with no signs of CVD (cardiovascular disease), only levels of NT-proBNP related to cTnI, and with the highest NT-proBNP levels in the high-cTnI group (p<0.01). A multiple regression analysis showed that NT-proBNP was independently related to cTnI (p<0.001). CONCLUSIONS: Measurement of cardiac troponins with highly sensitive assays identifies those at risk of premature CVD death who have hitherto remained unrecognized. The associated elevations of NT-proBNP in these participants support the fact that these elevations reflect ongoing pathological processes in the myocardium.